Lars Jørgen Østergaard

Reasons for hospitalization in HIV-infected children in West Africa

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • Fatoumata Dicko, Service Pédiatrie Centre Hospitalier, Universitaire Gabriel Toure, Bamako, Mali.
  • ,
  • Sophie Desmonde, Inserm, Centre Inserm U897 - Epidémiologie - Biostatistiques, University of Bordeaux, Bordeaux, France; University of Bordeaux, ISPED, Centre Inserm U897 - Epidémiologie - Biostatistiques, Bordeaux, France; Sophie.Desmonde@isped.u-bordeaux2.fr.
  • ,
  • Sikiratou Koumakpai, Service Pédiatrie, Centre National Hospitalier Universitaire, Cotonou, Bénin., Unknown
  • Hélène Dior-Mbodj, Hopital pour Enfants Albert Royer, Dakar, Sénégal., Unknown
  • Fla Kouéta, Service Pédiatrie, Hopital Général de Gaulle, Ouagadougou, Burkina Faso.
  • ,
  • Novisi Baeta, Korle Bu Teaching Hospital, Accra, Ghana., Unknown
  • Niaboula Koné, Service Pédiatrie Centre Hospitalier, Universitaire Gabriel Toure, Bamako, Mali.
  • ,
  • Jocelyn Akakpo, Service Pédiatrie, Centre National Hospitalier Universitaire, Cotonou, Bénin.
  • ,
  • Haby Signate Sy, Hopital pour Enfants Albert Royer, Dakar, Sénégal.
  • ,
  • Diarra Ye, Service Pédiatrie, Hopital Général de Gaulle, Ouagadougou, Burkina Faso.
  • ,
  • Lorna Renner, Korle Bu Teaching Hospital, Accra, Ghana.
  • ,
  • Charlotte Lewden, Inserm, Centre Inserm U897 - Epidémiologie - Biostatistiques, University of Bordeaux, Bordeaux, France; University of Bordeaux, ISPED, Centre Inserm U897 - Epidémiologie - Biostatistiques, Bordeaux, France.
  • ,
  • Valériane Leroy, Inserm, Centre Inserm U897 - Epidémiologie - Biostatistiques, University of Bordeaux, Bordeaux, France; University of Bordeaux, ISPED, Centre Inserm U897 - Epidémiologie - Biostatistiques, Bordeaux, France.
  • ,
  • Pediatric IeDEA West Africa Working Group (Christian Erikstrup, Alex Laursen, Christian Wejse, Lars Østergaard; members)

INTRODUCTION: Current knowledge on morbidity and mortality in HIV-infected children comes from data collected in specific research programmes, which may offer a different standard of care compared to routine care. We described hospitalization data within a large observational cohort of HIV-infected children in West Africa (IeDEA West Africa collaboration).

METHODS: We performed a six-month prospective multicentre survey from April to October 2010 in five HIV-specialized paediatric hospital wards in Ouagadougou, Accra, Cotonou, Dakar and Bamako. Baseline and follow-up data during hospitalization were recorded using a standardized clinical form, and extracted from hospitalization files and local databases. Event validation committees reviewed diagnoses within each centre. HIV-related events were defined according to the WHO definitions.

RESULTS: From April to October 2010, 155 HIV-infected children were hospitalized; median age was 3 years [1-8]. Among them, 90 (58%) were confirmed for HIV infection during their stay; 138 (89%) were already receiving cotrimoxazole prophylaxis and 64 children (40%) had initiated antiretroviral therapy (ART). The median length of stay was 13 days (IQR: 7-23); 25 children (16%) died during hospitalization and four (3%) were transferred out. The leading causes of hospitalization were WHO stage 3 opportunistic infections (37%), non-AIDS-defining events (28%), cachexia and other WHO stage 4 events (25%).

CONCLUSIONS: Overall, most causes of hospitalizations were HIV related but one hospitalization in three was caused by a non-AIDS-defining event, mostly in children on ART. HIV-related fatality is also high despite the scaling-up of access to ART in resource-limited settings.

Original languageEnglish
JournalInternational AIDS Society. Journal
Volume17
Pages (from-to)18818
ISSN1758-2652
DOIs
Publication statusPublished - 2014

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